Published by Oxford University Press on behalf of the International Epidemiological Association © The Author 2007; all rights reserved.
Commentary: Using innovative inequality measures in epidemiology
Department of Epidemiology, Biostatistics and Occupational Health, McGill University, Montreal, Canada.
*Corresponding author. Department of Epidemiology, Biostatistics and Occupational Health, McGill University, Montreal, Canada. E-mail: sam.harper@mcgill.ca
Accepted 6 June 2007
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Zhang and Wang1 use the concentration index (CI) to examine changes in income-related inequalities in overweight among US adolescents (aged 10–18) between 1971 and 2000. Their findings were heterogeneous and do not suggest any simple interpretation. They concluded that the expected inverse associations between income and overweight were not always present and differed across race/ethnic groups and over time. Between 1971 and 2000, the extent of income-related inequality in overweight generally diminished, mainly because of growing overweight among more socially advantaged adolescents. They recommend that interventions should not focus only on socially disadvantaged groups but instead target the whole population because there are many overweight adolescents in every social group.
There are several themes that emerge from Zhang and Wang's work that are relevant to understanding and measuring how social factors affect health. The heterogeneity of their findings implies specificity of mechanisms linking social processes with health processes, in this
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